Safe at the Plate

Be kind to your stomach and stay alert to avoid food poisoning.

A gut-twisting case of stomach cramps from food poisoning can not only be painful, but it can also sideline you from your job. Wary drivers in search of a good meal can take precautions to avoid food poisoning, or foodborne disease, while on the road and at home.

How big a threat is food poisoning? Foodborne diseases hit 76 million people each year in the United States, killing 5,000 and putting another 325,000 in the hospital, according to estimates by the Centers for Disease Control and Prevention. The most severe cases tend to occur in the very old, the very young, those who already have an illness that reduces their immune system function, and in healthy people exposed to a very high dose of a foodborne disease.

You can protect yourself on the road by choosing which restaurant to patronize. The local health department inspects restaurants to make sure they are clean and have adequate kitchen facilities. If you can, find out how restaurants did on their most recent inspections, and use that score to help guide your choice. In many areas, the latest inspection score is posted in the restaurant. Look for it when you walk in, or, if you are concerned, ask your server where it is posted and check it out. In some parts of the country the scores are available on city or county government websites. Good restaurants train their staff in principles of food safety. Ask your server.

You can also protect yourself from foodborne disease when ordering specific foods, just as you would at home. When ordering a hamburger, ask for it to be cooked to a temperature of 160 degrees and send it back if it is still pink in the middle. Before you order something that is made with egg or many eggs pooled together, such as scrambled eggs, omelets or French toast, ask if it was made with pasteurized egg, and choose something else if it was not.

Foodborne disease is caused by consuming contaminated foods or beverages. Many different disease-causing microbes, or pathogens, can contaminate foods. There are more than 250 different foodborne infections. Most of these diseases are infections, caused by a variety of bacteria, viruses and parasites that can be foodborne. Other diseases are poisonings, caused by harmful toxins or chemicals that have contaminated the food – for example, poisonous mushrooms. The microbe or toxin enters the body through the gastrointestinal tract and often causes the first symptoms there, so nausea, vomiting, abdominal cramps and diarrhea are common symptoms in many foodborne diseases.

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The most common foodborne infections are those caused by the bacteria Campylobacter, Salmonella and E. coli. Some common diseases are also occasionally foodborne, even though they are usually transmitted by other routes, including hepatitis A. Even strep throat has been transmitted occasionally through food.

Some foodborne diseases are caused by the presence of a toxin in the food that was produced by a microbe in the food. For example, the bacterium Staphylococcus aureus can grow in some foods and produce a toxin that causes intense vomiting. The rare but deadly disease botulism occurs when the bacterium Clostridium botulinum grows and produces a powerful paralytic toxin in foods. These toxins can produce illness even if the microbes that produced them are no longer there.

After the microbe is swallowed, there is an incubation period before the symptoms of illness begin. This period may range from hours to days, depending on the organism and on how many of them were swallowed. During the incubation period, the microbes pass through the stomach into the intestine, attach to the cells lining the intestinal walls and begin to multiply there.

Illnesses that cause diarrhea or vomiting can lead to dehydration if the person loses more body fluids and salts (electrolytes) than they take in. Replacing the lost fluids and electrolytes and keeping up with fluid intake are important. If diarrhea is severe, oral rehydration solutions such as Ceralyte, Pedialyte or Oralyte should be drunk to prevent dehydration. Sports drinks do not replace the losses correctly and should not be used for the treatment of diarrheal illness.

Bismuth subsalicylate (Pepto Bismol) can reduce the duration and severity of simple diarrhea. If diarrhea and cramps occur, without bloody stools or fever, taking an antidiarrheal medication may provide relief, but these medications should be avoided if there is high fever or blood in the stools because they may make the illness worse.

Tips for cooking at home or on the road
COOK meat, poultry and eggs thoroughly. Using a thermometer to measure the internal temperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. Use a chart to know if the meat is done. (There are many on the Web, e.g. this site)

SEPARATE: Don’t cross-contaminate one food with another. Avoid cross-contamination by washing hands, utensils and cutting boards after they have been in contact with other food, especially raw meat or poultry, and before they touch another food.

CHILL: Refrigerate leftovers promptly. Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are not going to be eaten within four hours.

CLEAN: Wash produce. Rinse fresh fruits and vegetables in running tap water to remove visible dirt and grime. Remove and discard the outermost leaves of a head of lettuce or cabbage. Because bacteria can grow well on the cut surface of a fruit or vegetable, be careful not to contaminate these foods while slicing them up on the cutting board, and avoid leaving cut produce at room temperature for many hours. Wash your hands with soap and water before preparing food.

REPORT: Report suspected foodborne illnesses to your local health department. Often, calls from concerned citizens are how outbreaks are first detected. If a public health official contacts you to find out more about an illness you had, your cooperation is important.

Do You Need a Doctor?
A health care provider should be consulted for a diarrheal illness if it is accompanied by:

  • High fever (temperature over 101.5 degrees F, measured orally)
  • Blood in the stools
  • Prolonged vomiting that prevents keeping liquids down (which can lead to dehydration)
  • Signs of dehydration, including a decrease in urination, a dry mouth and throat, and feeling dizzy when standing up.
  • Diarrheal illness that lasts more than 3 days.

Source: Centers for Disease Control and Prevention

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